I was walking through the mall tonight, and there it was -- right in front of me. There was a very pretty college-aged girl standing there, wearing one of the t-shirts I created and sell. It was white, long-sleeved, and said on the front "Can't afford your copayment? ... Let me have 10 of your cigarettes." [It also showed 10 cartoon cigarettes scattered about] 

My face lit up like a kid a Christmas, although she wouldn't notice me in such a crowded place.

As she turned and walked away from me, I smiled when I saw:

Last year, for Christmas, a non-pharmacist friend bought me what he thought was the "perfect gift." He told me not to get him anything -- it was just a trinket that he found on the internet that I would enjoy. A few days after Christmas we met up for lunch and he handed me this mug. I smiled and thanked him cordially, but I didn't tell him the full truth. He bought me a mug I sold him...So, I got the mug AND a royalty fee...:-)

Of course, this now gives me the perfect opportunity to hock my stupid shirts, but I'm not going to waste it. I'm proud of some of them -- while some of them are complete crap. However, since it is very close to Christmas again, and I have noticed a recent upswing in sales. I'll share the main link to the page, the best of my gallery / highest sellers, and give you the opportunity to check them out...or not...whatever...

The Angriest Pharmacist Main StoreFront

Best Seller:   "Your doctor had one semester of pharmacology..."

Lady's Choice: "I married a pharmacist..."

TAestP's Personal Favorites: "Not good with Advice" - "Believe and Doubt" -
"Pharmacist: ALL things to ALL People ALL of the time!"

Recently sold 10 to University of the Pacific's Admissions Dept: "There are two people..."

Favorite of asshole men (like me): "I have a doctorate in pharmacy..."

Best selling inanimate object:  "Pharmacist Blend..."

Stupid Patient Excuses: "Believe me, I've heard it ALL..."

Toddler's Favorite: "Daddy sells drugs..." or "My dad sells Norco and Soma to losers..."

Fibromyalgian's Favorite: "Fibromyalgia..." and "Fatsomyalgia"

Most likely to be bought the The Angry Pharmacist: "Fuck off...I'm drinking" or "Alcohol"

Most likely to be bought by @PimpinPills: "It's the fanclub I can't stand..."
or "These don't fill the prescription..."

So, that was a little longer that I would've liked. I guess I'm just proud of my silly shit. Thanks for looking. Have a good one...

4) REPLY TO ALL FAXES REQUESTING YOU GET A PRIOR AUTHORIZATION BY SIGNING IT AND AUTHORIZING "1+2" REFILLS. This is a GREAT way to both waste a pharmacist's time and really frustrate them. In most instances, they've told the patient 48-72 hours. By replying to the fax with refills, you show that you really want the patient to get the medicine, but it shows the pharmacy that you've got better things to do than read their stupid faxes. To really put a cherry on top of this one, schedule the fax to send at 4:55pm. This will ensure that even if the fax even goes through successfully in the first place, the pharmacy can't contact you again until the next day because the phones cut off at 5pm on the dot (and you cut out at 4:30pm in the first place)!

3) When they call you the next morning, make sure they have to leave you a voicemail. If you're feeling particularly randy, respond to that with a copy of the fax from the day before and a SNARKY  NOTE at the bottom of the fax. Some suggestions for the note are:
"Authorized (1+2) yesterday. Is your fax machine working?"
"I got your VM -- here's the auth you need. Thought I faxed this yesterday. WEIRD!!
You could also just skip the reply all together...

2) When they finally get a hold of you at the end of the second or the third day, tell them your office's standard is at least 3-5 business days on a PA Request. Tell them you'll get back with them at the beginning of next week. After you say this, don't do anything. Don't even ATTEMPT to get the prior authorization. Why you ask? Duh -- the pharmacist will probably call and remind you again on Tuesday or Wednesday when you actually need to do it anyway. Out of sight out of mind! [If you wanna be a real bitch, at this point you need to send another refill authorization in to pharmacy. No note this time -- you don't want to appear "catty."]

1) After they call you Wednesday, if it's a different pharmacist than the one you talked to the previous week you need to go off on him. Make a huge scene. Act as if everything that was sent in and you cannot figure out why the pharmacy refuses to fill the prescription. When they explain the PA Process to you, acknowledge it, say you'll get right on top of it, and completely ignore every word of it. At this point you need to go straight to your doctor and tell them the following, "Doc, I don't know what the heck is wrong with Walgreens. They are pretty much refusing to fill Mr. Johnson's _________.  I've dealt with several different members of their staff. I've faxed in the prescription at least two different times, called it in once, and I can't seem to get them to fill it!" Then, the doctor will call and ABSOLUTELY TEAR THAT STUPID PHARMACIST A NEW ONE! Sit back and laugh. You've done a good job. You've waste almost a week of the pharmacist's time, and you've not had to do much work or call for the PA.

Final Step) Now, when the doctor returns to you,  he'll explain to you that they just need you to get a PA. They'll be so scared of the doctor, they won't say anything about your prior shenanigans. Your response should be, "Well, why didn't they just SAY THAT!?! STUPID PHARMACISTS!" He will agree and, at this point, you need to call the pharmacy again and have them fax you the information on how to get the Prior Authorization. They will probably say something about how they sent you the information -- just tell them you never got anything. Now, buckle down and actually get the PA...dag nabbit!!

And that is how you get a PA!

The title of this post really says it all, amiright? If you've worked in service of customers/patients, in any field, some jackass has uttered (or hollered) these words in an outlandish attempt at getting their way by bartering all of their money for future services rendered in exchange for instant gratification in the form of (most likely) you compromising your better judgment.

Obviously, this has happened to me quite recently...and it pissed me off royally because I was the nice guy being lied to and this fat bitch was the fat bitch that altered her prescription and lied to a(nother) pharmacist.

She presented a prescription from a doctor for that read as follows:

Pt: Janice Sanveritas

Hydrocodone/APAP  5/500
Sig: 1-2 tabs po q4-6h prn pain.

Dr. Ima Schmuch, DDS

Now, most reasonable people can see that this prescription LACKS A QUANTITY. She brought this to me at, we'll say 1pm on Sunday. After I IMMEDIATELY pointed out that it lacked a quantity and would require a phone call the next day, she remarked that she thought that this was the case, but she convinced herself that the word "SIG" which was scribbled was in fact the word SIXTY. Of course, this would be ridiculous because it is very UNcommon for a dentist to write for SIXTY FUCKING VICODIN. So, we argued about this a bit and decided that she was mad at the dentist for not writing a quantity and not me, but she was pretty sure he told her sixty....considering this lady had been a problem in the past, I didn't care what she thought, I wasn't even gonna give her 1 or 2 for that night (which I might CONSIDER, for a second, if she was a consistent, good, nice, polite patient).

So, she left script in tow. She came back at about 3pm. Now, the script had a convenient #60 written in right beneath the Sig. The ink didn't match. The hand writing didn't match. The story made no sense. She told me the drove over to this dentist's office and caught him just as he was leaving and he apologize profusely as he wrote in that #60 in a different handwriting from 6 or 7 days prior. I called his office the first time she came in and of course, nobody answered. In fact, it went straight to voicemail as if no one were in the office. I left a message at that time, but I knew no one would get it until Monday. Luckily he was there, right?

I told her, right when she handed it to me that I was going to have to call and verify the quantity...and the drama and bullshit began. You all know how this went.

"I have to call and verify this."
"Why? He wrote the quantity in plain as day. You can see it right there."
"Yes, but you must understand why I have to verify this. It's Sunday afternoon. I've seen this script without a quantity and you bring it back and now it has a quantity written on it. If your dentist DID write this in, he should have called or at least initialed next to the quantity that he wrote it in a different colored ink. He knows better. He knows how things are these days with all those druggies out there."
"Ohh so now you're calling me a druggie?"
"I don't recall saying that specific phrase. Did I say that?"
"Well, you might as well. I'll tell you what I'm fucking sick of this place. Every time I have fucking problems because you're a fucking idiot. I'm NEVER COMING HERE AGAIN!"
"And that's completely fine with me. I just want you to at least accept that you know where I'm coming from. I have to verify that quantity on that script. You've had it for several days. What's 18 more hours? I can call in the morning before I even open."
"No, just give it back to me. I'm going somewhere else. This is ridiculous. I've been coming here for 10 years. [Note: this pharmacy has only been open for 4-5 years] I'm going somewhere else, and I'm transferring all my meds away, and I'm never coming here again. Someone else would be more than happy to accept my business."
"Okay...fine...good bye" [and good fucking riddance]

-=+=-

I wanted to say, "Do you really think, for one second, that I'm not going to call every pharmacy in town the SECOND you walk out of here and let them know that you are leaving here with a prescription that I believe to be altered?"    But, that would ruin all the fun of wasting her time! I WANTED her to take it to another pharmacy -- or several if possible -- only for her to be turned away for the EXACT same reasoning. I also wanted to write something on the prescription, but that would've also kept her from mustering up the gaul to take it elsewhere.

So, I took to calling all 8 pharmacies in my vicinity. Turns out this fat bitch was already BANNED from Wal-Mart, a Medicap, and a Medicine Shoppe.  Now, she can add one more pharmacy to that list for her bullshit.

The winner of the "where this bitch ended up" contest was CVS. I'd talked to their pharmacist Remy, and she politely called me back. She let her drop it off and return 30 minutes later. Remy told her that the quantity's ink did not match the rest of the prescription and that she had no choice but to call the next day and verify it. This bitch politely said, "Okay, thanks a lot!" and putted her ass right on out of there...after showing her ass real good right in front of my eyes!

Today rolls around and I head in there and first thing call that dentist's office and apprise them of the situation. I told them that I believe that she modified the prescription, but CVS currently possessed the hard copy and would be calling. I just wanted to tell them my side of the story. Their side of the story? He intended on giving her 20 tablets and was nowhere near the office on Sunday.

Cut ahead to Remy calling me later on...She verified the script was altered by someone, and the DDS intended on 20 tablets. However, he went ahead and AUTHORIZED TWENTY TABLETS TO BE FILLED! I could not fucking believe it. Remy couldn't believe it. Hell, the fucking patient probably couldn't believe. This was the only doctor in the fucking NATION that would approve that script. He is enabling her addiction -- no doubt about it. This fucking doctor is a problem. I am debating whether or not to call the Board of Pharmacy and the Board of Medicine. I'm not sure if there's grounds for any sort of investigation -- or if I would just end up looking like a tight ass, punk pharmacist...

What are your thoughts?

I've got a pretty good system installed. I can replay or even fast forward or rewind a second by pressing a button (many seconds if hit repeatedly). But, when nurses are calling in these fucking scripts as one long word, it doesn't matter. Worst of all, no one spells anymore - Not patient names, not doctor names, nothing.

Case in point: Nurse today called in an Rx that sounded like this (read as fast as possible and slur the words together) -- "Hey this is Ann calling from doctor Badduda first name Mowaffaq prescription is for Shalonda Teddleston date of birth 5-5-75 for Lortab 7.5 #15 taken 1 BID prn pain office call back number is 555-6969."

Here's what is wrong with this voicemail:
1. She works for a foreign doctor. You have GOT to spell those names. I could care less where they are from, but I'm not familiar with spelling of their names. If it were John Smith, I'm cool with it. It's not. Spell the fucking name.
2. Patient's name could be spelled multiple ways. Is the last name spelled with T's or D's -- they sound the same in a crappily left message.
3. Birthday of May 5th? FIVE FIVE sounds like NINE NINE. Make sure you are audible!
4. Lortab was mumbled. I misheard it. I originally wrote down FORTAZ. Of course, once I reread it, it didn't make sense. So, I read between the lines. (Fortaz is an injectable antibiotic and wouldn't be given prn and it's a 1g+ dose -- not 7.5mg).
5. In a fast, mumbled message, BID can sound like TID. How much fucking more time does it take to say twice a day or every 12 hours?
6. Office number is always given so fast it's pretty much inaudible. You know it by heart, I don't. Would you fucking slow down?

As you can see, the voicemail system has given me 6 opportunities to screw something up in a 15 second voicemail. If the voicemail had been 30 seconds and the bitch had slowed down a bit, there would have been no problems on my end and no gripes.

There's just no rationalization these fucking LPNs and RNs can give that makes this ok. It's unsafe. They sound more retarded than they actually are, and they are putting our 'healthcare team' at risk for making a dangerous mistake...all because they don't have an extra 15-20 seconds to speak slower. Way to go, bitches.

Now, the fun goes both ways. I've been known to leave a fast voicemail in my day -- mostly in response to this kind of bullshit. Next time I have a refill request for this bitch, I'm gonna talk as fast as possible. She won't get it. She won't put one and one together (well, if she does, she'll get eight).

Most of my calling has been converted to faxing. I'm pushing to move ALL of it there....because of this bullshit.

I'll probably call her tomorrow and explain the situation to her...slowly. See if maybe I can reason with her. It won't work, but maybe, just maybe, the hamster wheel in her head will turn a few times and she can spare 15 seconds for me.

-=+=-

Here's a fun game I like to play. Some nurses call in and "want to talk to the pharmacist" to phone in a prescription. When I get fast talked, and I'm actually TALKING to the asshole --err-- nurse, I always take my time. I write as slow as possible. I repeat everything, maybe even twice. I speak as if I've had a stroke and in a thick southern accent...think Deliverance mixed with Cleveland from Family Guy. I love it when they get frustrated and try to hurry up and get off the phone. "Just to make sure I get everything right, please repeat the prescription back to me again." I end the phone call by saying that they need to slow down a little bit or the patient could be the one that pays for their haste. "Would you rather me fill your child's prescription as fast as possible, or diligent and correctly? Only one can happen. Your haste makes mistakes. If you don't have time to call in a prescription get a fax machine, hire more help, or call them all in at the end of the day when you have time. Your patients will wait, they have no choice, and they will rejoice that you are giving them Toprol rather than Topamax."